To explore the effect of exercise intervention on fundamental movement skills (FMS) of children with attention deficit hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD). Following the principle of PICOS, randomized controlled trials of the effect of exercise intervention on the FMS of ADHD/ASD children were searched. A total of 12 articles and 396 participants were included. Review Manager5.4 and Stata16.0 software were used to process and analyze the data. The results revealed that (1) exercise intervention can improve the gross motor skills of children with ADHD/ASD (p < 0.00001). Aquatic therapy (SMD = 56.54, 95% CI = 38.83–74.25) has a better effect on stability skills, and FMS intervention (SMD = 17.58, 95% CI = 1.78–33.38) has a better effect on locomotor skills and object control skills. (2) Exercise intervention can improve the fine motor skills of children with ADHD/ASD (p = 0.001). Table tennis exercise (SMD = 9.91, 95% CI = 0.23–19.59) and horse-riding program (SMD = 9.50, 95% CI = 5.20–13.80) have better effects on fine manual control and hand–eye coordination. (3) The closed-skill intervention for 60 min each time, twice a week, for at least 12 weeks had the best effect on the improvement in the FMS in children with ADHD/ASD (p < 0.00001). Exercise intervention may effectively improve FMS in children with ADHD/ASD. Intervention form, time, frequency, and duration are important moderator variables that positively impact the FMS of children with ADHD/ASD.

Accurate assessment of children’s fundamental motor skills (FMS) is crucial for promoting lifelong healthy development and formulating effective physical education policies. However, China currently lacks standardized assessment tools that cover the entire age range from 3 to 12 years and have undergone thorough cultural adaptation. This study aimed to evaluate the psychometric properties and cultural adaptability of the MOBAK assessment tool in measuring FMS in Chinese children aged 3 to 12 years. A total of 1200 Chinese children from four regions of China participated in the study, including 623 boys (52%) and 577 girls (48%). The MOBAK tool was used to assess FMS across different age groups, focusing on two dimensions: object movement (e.g., throwing, catching, bouncing, and dribbling) and self-movement (e.g., balancing, rolling, jumping, and running). The study evaluated psychometric properties, including reliability and validity. Results indicate that MOBAK demonstrates excellent psychometric characteristics: (1) Good item discrimination (all CR values p < 0.001), with an appropriate difficulty index (0.51–0.67); (2) Extremely high reliability, manifested by high internal consistency (α > 0.80), high test–retest stability, and high inter-rater consistency (ICC > 0.90); (3) Robust construct validity, supported by exploratory and confirmatory factor analyses, which consistently confirmed the hypothesized two-factor model and had excellent fit indicators (CFI/TLI > 0.90, RMSEA/SRMR < 0.08). The MOBAK battery demonstrates strong psychometric properties and cultural validity in the Chinese context for reliably assessing FMS in children aged 3–12 years. These findings provide a foundation for future cross-cultural comparisons and validation studies in other populations.